Newbie Question: Alpha Trak

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Anna K

Member Since 2014
Hi!

I just tested Bruno for the first time this morning, pre shot and pre food. His number is 150.

Two questions:

1. Is the spreadsheet with colors coded for Alpha Trak or human bg monitors? Should I be modifying my numbers?

2. How are you all successful with the lance that comes with Alpha Trak? I dialed it up to 4 and it still took forever. Most of my pokes did not even touch his ear. This is hard to learn!

Luckily my boy is sweet and gentle, used to pills and shots. He doesn't complain too much :)
 
Hello Anna and extra sweet Bruno!

First, if you're going to continue to use the Alpha Trak, just put it in your signature as well as on your spreadsheet in the "Remarks"...Make sure it's clearly visible in both places since the majority of us use human glucometers. You might want to make the font large as well as a different color so we see it!

As I said, most of us use the human glucometers because of the cost of the replacement strips for the Alpha, as well as the fact you have to either order them off of someplace like Ebay or get them from your vet, and it just seems to work out that when you need them the most (like a 3am when your cat's blood glucose is 32) is when you run out of strips and there's no way to get more.

Human meters work fine, and are much cheaper to use. From what I've read, the strips on the Alpha can be $1-2 each, and with as much testing as we do here (an average of 6 times/day) that runs into a major expense! The Relion meters from WalMart have strips for as little as $9 for 50, so you can see that's a huge saving.

You're really better off saving your money for better food or something special for your kitty instead of spending it on the Alpha strips.

You don't need to change your numbers on the spreadsheet as long as we know you're using the Alpha (or if you go to a human meter, just make sure there's a distinct line between tests done with the Alpha and tests done with a human meter)

On the ear poking, are you heating the ear before you poke? A couple of teaspoons of rice or oatmeal in a small sock that you microwave can make a big difference. Another thing to try is a pill bottle or film canister filled with warm water. You want to test on your wrist like you would a baby bottle to make sure it's not too hot, then hold it against the ear for several seconds. This can help bring the blood up into the ear.

150 is a great pre-shot number! Look forward to seeing your spreadsheet and following you and Bruno along!
 
You are welcome to shift the colors on the spreadsheet, using the following information, if you continue with the AlphaTrak.

We suggest using an inexpensive human glucometer with pet-specific reference numbers. One many of us use is the WalMart Relion Confirm, or Confirm Micro, which is also sold at American Diabetes Wholesale as as the Arkray USA Glucocard 01 or 01 Mini (same manufacturer - Arkray USA). It uses a tiny blood droplet and the cost is significantly lower for test strips (like $0.36 each).

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
So the only downside to Alpha Trak is the price of the strips, right? It's totally fine to use? I have a bunch of these strips so I will go through them before switching to anything else. I bought them on Amazon btw.

My question was about the colors (pink, yellow, red, etc). I suppose My 150 reading would be like a 120 for you guys right? I will try to shift the colors on the google spreadsheet, if I can figure out how!

On another note, I'm happy to know after spending a lot of time on this board that I have a great vet! She did not provide the depth info that you guys do, but all the info she provided was in agreement with this board.

Thank you everyone! This board is great!!
 
It is absolutely fine to use. We just really need to notice that, though, because the number interpretation differs - hence the request to put it in your signature with a large font, bolded or with a bright color for attention.

And if you want to change the color coding that's fine. I've tweaked the coding on my spreadsheet for Gracie, because I think she's starting to have some lower pre-shots and want to be able to spot that more easily.
 
Yes the Alpha is fine to use or you can always keep it as a back up meter. Like running out of strips at 3am, if the meter you end up using is going to fail, it's going to fail at the worst times, so having an "extra" meter around (with strips) is always a good idea anyway

I wouldn't bother trying to fool with the color coding, especially if you're just going to go to a human meter later. (then you'd have to go back and figure out how to re-code it back) Just make sure you note that the numbers you're putting in were using the AlphaTrak...and it wouldn't hurt to re-add that info every now and then in the "remarks" area instead of just putting it in at the top. As you get more days in and people start scrolling down to see the latest results, if the only place it says that you're using the Alpha is at the top, it might get missed.

If you continue with it, maybe once/month or every 2 weeks, add that you're using the Alpha to the remarks and color code the cell something different. That'll help make sure we notice it

As long as we know you're using the Alpha, you don't need to add anything to the numbers. Just enter what you get
 
Sorry, I wasn't clear. I meant, when I am looking at the tight protocol (Tilly's or the other one) I should interpret these by adding 30?
 
Oh OK..Scroll back up to the post by BJM. She has listed the values in human, Alpha and non-US terms of some of the more important "milestones" in the protocols.

Numbers in curly braces are estimates for an AlphaTrak.

Those are the numbers used in both the Tilly and our TR protocol.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]
 
Thanks everyone!

Ugh, I just tried to take his second blood sample today and I couldn't get the lance to make a puncture. Am I being too tentative with how I hold it? I pressed his ear to the clear plastic thing. I warmed the ear first. I dialed it to 4. No puncture. It touched him, but no blood came. I'm going to try again in a bit. My Bruno was very patient, did not fight but then my two minutes were up and the Alpha Trak beeped and that made him run away. I turned off the sound after that. NO sound next time! He's eating a snack now, I don't know what effect that will have on the next reading. But I'll try again in a bit.
 
Are you firmly backing up the ear where you "prick" the ear? If not the ear will be deflected and not punctured. I use a cotton makeup pad. I find it works better than a cotton ball.
 
I finally got it to work. I took the lance out of the little lance holder (what do you call it) and just jabbed without the mechanism. Yes, cotton backing. I think he liked this better because he didn't like the sound of it releasing, it was a springy plasticy sound.

This is hard! His +6 reading was 61 Alpha Trak. So I gave him a big snack.

Should I reduce his PM dose? 61 on Alpha Trak is like 31 for the rest of you right?? This is hard because we have so little data. He has been on insulin only one week, 1 unit twice a day.

Today was the first day we started home testing.

This is his chart, although there are only two readings so far: https://docs.google.com/spreadsheet/ccc ... _web#gid=0

Remember: Alpha Trak! :)
 
Good for you on the successful poking! I like freehanding better too!!

YES on the reduction!!

And right now you need to be giving him a teaspoon of Gravy off of a Gravy Lovers food,(or other high carb food) or a couple of drops of syrup, honey or Karo with a teaspoon of his regular food. The carbs are in the gravy...that's why we suggest the gravy lovers foods. It doesn't fill them up too fast either

We need to get him above 80! You will want to re-test every 15 minutes or so and if he remains under 80, repeat the above until he is. You don't want to give him too much at one time because you may want him to be willing to eat later, so you don't want to fill him up all at once.

One he's above 80, then you can stop feeding, but keep testing for at least 2 hours after that. You want to make sure he stays above 80 without feeding.

Tonight, drop him back to .75 unit

Edited to add...I see you gave him a snack...Keep testing and make sure he gets above 80 and stays there. You're doing great!
 
Thanks.

He is up to 71 now. I don't have any of those gravy foods here but I had a can of i/d from before he was diabetic, and it's higher carb. So he's eating that now and I'll retest in a bit. Then if it's still low I'll rub honey on his gums. I don't want to go straight to honey if this food works. He is acting totally normal, and starting to get mad about the ear pricks. Which I am getting better at, by the way :)

Thanks so much,
Anna
 
You don't need to rub it on his gums unless he's unresponsive.

As long as he's willing to eat, you can give a little more food, or add the honey, syrup or Karo to his regular low carb food. We want to try to bring them up gently, without sending them through the roof.

Next time you go shopping, get some of the Gravy Lovers Fancy Feasts. As I said earlier, the gravy part is where the carbs are, so you can give a teaspoon or two at a time without worrying if they're going to get too full and not want to eat for you later if you need them to.

If you pop the top and then press it down against the food, the gravy part will "ooze out" and you can collect it in a small bowl and then spoon it out as needed. (it's messy, but effective)

Don't be surprised if later tonight or tomorrow, he throws a big number at you. We'd expect him to "bounce" since he went so low. If it doesn't happen, great, but more than likely, it will.

Keep feeding until he's above 80 and then keep testing to make sure he doesn't drop back down. Hopefully he's past his nadir and will come up on his own, but you don't want to risk it when they drop that low. 30's are not to be taken lightly.

You're doing great! Keep it up!

Don't forget to add that you're using the AlphaTrak on your spreadsheet, and then you can put the link in your signature box with the other information already there. That way it'll automatically come up every time you post so people can quickly check your latest numbers.
 
I really don't know about the dog food gravy, but if he's coming up ok with what you're doing, you can keep it up.

Just don't feed him a whole lot of the higher carb food in case you do need to get him to eat later. The trick is to bring them up, but not too much, and then make sure they stay up without any more food of any kind.
 
He's up to 78. Thank you.

If he bounces (goes high numbers tonight), I am still to give him the lower insulin dose correct (.75)?

Thanks so much for all your help!! This board is great!

One more dumb question: Bruno is only 8.5 pounds. So one unit for him is really not that small is it? It would be like two units for a big 17 pound cat, right?
 
It doesn't really work that way...bigger cat needing more insulin. It all depends on how sensitive each cat is to carbs, how much of their pancreas is still working, and a million other little details that are unique to each cat.

The general starting formula is 0.25 unit per kg of the cat's ideal weight
If kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight

From there, we just see how the cat reacts to the dose. Two cats can weigh the exact same, but need drastically different doses to stay in good numbers due to all the other variables

There is something called "Shooting through the bounce" when you give one more dose at the higher rate and then take the reduction on the next cycle. This is used when they bounce really high by the next Pre-shot. (Like over 300) You'd still want to be able to monitor closely if you "shoot through the bounce" because a lot of cats become more sensitive to insulin right after going too low.

If Bruno "bounces" into the 300's or higher by PMPS time, you could choose to shoot through the bounce and go ahead and give 1 unit again, and then start the .75 tomorrow, or you can go ahead and take the reduction tonight.
 
Aha. Thanks for all this info. Yes poor Bruno is a little underweight, because he has lymphoma. We are always trying to get him to eat more.

Thank you for all your help Chris, you are wonderful! :-D
 
Hi! I'm Kati and my big Sugarcat is Fred (age14).

I was just looking over your posts and wanted to add that the Relion test strips and meters are available at Walmart in the pharmacy section and they are affordable...you can buy in different quantities to suit your budget and my meter (used also by humans) has lasted me for 4 years!

I get the thinnest lancets, also at Walmart, that have little twist-off caps. Then, I put Fred in my lap, head facing away, and spread his ear over a little cork coaster. Then I quickly lancet his ear between the vein and ear edge. I have the meter loaded and ready, so Fred knows he can get his treat as soon as he hears the meter ring!

It's a fairly easy operation that you and Bruno will get used to quickly. The thin lancets help with excessive bleeding, but it's always a good idea to put pressure on his ear to stop the blood flow, which can cause a little bruising - no biggie.

Don't forget to set up a picture of your handsome Bruno. And, of course, a spreadsheet will help all the really expert people on this site to see what's going on - that's important.....they saved Fred's life!!!
 
Thank you Kathleen! That is all good info. I got better at lancing but forgot to apply pressure and yes he is bruising, he's fair skinned (orange tabby)

Yes I have a spreadsheet. It is here:

https://docs.google.com/spreadsheet/pub ... utput=html
Remember: Alpha Trak so it's 30 higher than yours.

I have yet to add a photo avatar but you can see a photo of dear Bruno here:
http://instagram.com/p/ZVauH-t1cN/

He is a 13 year old orange tabby Devon Rex.

I am still confused about a couple of things so bear with me.

My vet said don't give insulin if he isn't eating or if he's throwing up. Correct?

This morning he barely ate. This may be because he had some late night snacks (I left the food out).

So I only gave him .5. Was this the right thing? Because he barely ate and because yesterday's low nadir reading freaked me out.

It is also really hard to do a .75 with my needles. I have the kind with one unit markings. What I actually did this morning was somewhere between .5 and.75, I can't tell. I just ordered the smaller kind with half unit markings.
 
We don't adjust the numbers for the AlphaTrak; we understand they read higher than human glucometers. It is like reading temperature in Celsius vs Fahrenheit. Both are correct.
 
What an adorable pic of Bruno!!!

I had to start using the needles with the 1/2 marks for ease in half doses. You will need to get your questions answered about insulin with vomiting for some of the "old head" around this site -- you've already connected with some. I can 'to give that kind of advice, because I'm too new, myself.

You may get more response as the day moves along. But, don't panic....it will get figured out!!
 
First, get some syringes with 1/2 unit markings. Again, WalMart carries them (although not all pharmacists seem to know that) so just ask for 3/10mL 30 or 31 gauge, 8mm insulin syringes with half unit markings. They make a Relion brand in those too. About $13 for 100

They make it much easier to get those .25 and .75 doses!

As for your other question, most of us Test/Feed/Shoot, all within about 10 minutes so we do make sure our cats are eating normally. If their appetite is down, we would probably still go ahead and shoot, but it would mean we'd want to get more tests in during the cycle. Usually, their appetite picks up later, but this is very much an ECID situation, and you have to do what feels right for YOU.

It's fine to give a BCS (Big Chicken S***) shot if you're concerned, and anything less than the dose "scheduled" can be considered a BCS shot. This at least gives some insulin, so doesn't drain the depot like skipping completely would. It does mean the 6 cycle "count" starts over though at the next scheduled correct dose, so if you'd been giving .75 for 4 cycles, and did a BCS on cycle 5, the next cycle of .75 would be cycle 1 again

With vomiting, it's kind of the same deal. Of course the WHY they're vomiting is important too. Scarf and barf's are pretty common, when they eat too fast and vomit it back up within 15 minutes or so. In those cases, just give them a rest for a few more minutes, then give 1 teaspoon every 15 minutes until they've eaten their normal amount. If they're vomiting due to being sick, you don't want to let that go too long without seeing a vet. Even a couple of days without eating can cause Fatty Liver disease and that's extremely hard to go through, as well as being very expensive.
 
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